New Medicare Initiative Aims to Fill Holes in Patient Health Records

July 31, 2019by Lauren Clason
Seema Verma, administrator of the Centers for Medicare & Medicaid Services with the U.S. Department of Health and Human Services, testifies before the Senate Committee on Homeland Security & Governmental Affairs on Capitol Hill on August 21, 2018, in Washington, D.C. (Ron Sachs/CNP/Zuma Press/TNS)

WASHINGTON — The Centers for Medicare and Medicaid Services on Tuesday unveiled a new initiative that aims to connect the dots between a patient’s health records held by different providers.

The Data at the Point of Care, or DPC, demonstration seeks to bridge the data gap by connecting Medicare’s Blue Button — a tool that allows Medicare patients to download their health records and save them in computer files or apps — directly to a patient’s doctor. A doctor could then see claims data from a patient’s other providers that might not be accessible otherwise.

The announcement came at a White House conference of software developers participating in the Blue Button initiative. The initiative is part of the administration’s efforts to help mitigate the fragmentation of the U.S. health care system and encourage doctors to coordinate care.

In some cases, Blue Button data could connect directly with a doctor’s electronic health records software. Providers can begin signing up for the pilot now, and CMS will start rolling out data in August.

Administrator Seema Verma told reporters Monday that the demo will begin to fill the holes that exist in doctors’ views of their patients’ health, citing one particular psychiatric practice that struggled to know when its patients were admitted to the emergency room.

“Many of them are reluctant to participate in value-based models because they don’t know what they’re getting into,” she said.

The additional data could encourage more doctors to join value-based arrangements, which pay based on a physician’s ability to keep patients healthy rather than the quantity of services they provide.

The department doesn’t have specific projections on how many providers will join the pilot, which Verma expects will grow over time. But CMS expects ample participation because Blue Button will give doctors “a pretty robust picture of a person’s health,” Verma said.

“It doesn’t provide an exact medical record, but at least they know where to go,” she said.

The move is the latest in a string of changes meant to improve health IT.

In February, CMS proposed two rules to facilitate the flow of patient data by, among other things, requiring health plans participating in government programs to make data available to patients in an API format — which would allow them to connect with third-party apps.

Those rules were met with resistance from some provider and tech groups, like the Health Innovation Alliance, which claim that guidelines on when providers can block access to data are too vague. But other IT experts, like former National Coordinator for Health IT Farzad Mostashari, have expressed their support.

CMS is also conducting a contest for ways to use artificial intelligence in predicting unplanned hospital and nursing home admissions. The next stage of the competition, which launched in March, will be announced Friday.

White House senior adviser Jared Kushner told reporters Monday the administration’s multipronged approach is moving the needle.

“I think we’re dangerously close to achieving some major breakthroughs,” he said.

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